2-year clinical performance of a fluoride-containing fissure sealant in young schoolchildren at caries risk

Abstract

Purpose: To evaluate the clinical performance of Helioseal-F, a fluoride-containing fissure sealant, in school children at caries risk.

Materials and methods: A caries risk assessment based on past caries experience, saliva microbial tests, buffer capacity and frequency of sugar intake was carried out in 204 healthy children, 6-7 years of age. Children exhibiting one or more risk factors were considered at caries risk (n = 121) and their permanent molars were sealed with a fluoride-containing fissure sealant, thus forming a fissure sealant group (FSG). The remaining 83 children with low caries risk received no fissure sealants and constituted a reference group (RG). Both groups were followed for 2 years. From 15 children of both groups, unstimulated whole saliva was collected 1 month after sealant placement in order to determine fluoride levels. In another 20 children, a split-mouth study design was utilized to compare the colonization of mutans streptococci adjacent to and on F-containing sealants and conventional controls. The sealants were placed by dental hygienists according to the manufacturers' instructions.

Results: A total of 431 fissure sealants were placed at baseline. Complete retention was found in 76.6% during the study period while 22.0% were partially lost. Six sealants (1.4%) were completely lost. The enamel caries incidence was 45% lower (P < 0.05) in the permanent molars of the caries risk FSG compared with the low risk RG. There was no significant increase in saliva fluoride concentration following placement of the sealants and the proportion of mutans streptococci in relation to total viable counts was unaffected by type of material. The levels of salivary mutans streptococci were mainly unchanged in both groups during the study period, while the levels of salivary lactobacilli decreased in the FSG.